The actual pandemic infection related to SARS-CoV2 results in viral pneumonitis (COVID-19), that may, in the more severe cases, lead the patients to the intensive care unit (ICU). The more frequent presentation is acute respiratory distress syndrome (ARDS). To penetrate cells, SARS-CoV2 uses Angioconvertase type 2 (ACE2) as a cellular entry receptor. ACE2 belong to the renin-angiotensin-aldosteron system (SRAA), and ACE2 levels are directly modified when SRAA inhibitors are administred to patients, and ACE2 level increases particularely with Angiotensin II Receptor blockers (ARA2) use. The aim of our study is to determine ACE2 level and activity in patients with SARSCoV2 infection admitted to the intensive care unit (ICU). COVID ARA2 is a propsective cohort of patient with blood sampling at the day of admission, day 3 and day 7.
The actual pandemic infection related to SARS-CoV2 results in viral pneumonitis (COVID-19), that may, in the more severe cases, lead the patients to the intensive care unit (ICU). The more frequent presentation is acute respiratory distress syndrome (ARDS). To penetrate cells, SARS-CoV2 uses Angioconvertase type 2 (ACE2) as a cellular entry receptor. ACE2 belong to the renin-angiotensin-aldosteron system (SRAA), and ACE2 levels are directly modified when SRAA inhibitors are administred to patients, and ACE2 level increases particularely with Angiotensin II Receptor Blockers (ARA2) use. The aim of our study is to determine ACE2 level and activity in patients with SARSCoV2 infection admitted to the intensive care unit (ICU). COVID ARA2 is a propsective cohort of patient with blood sampling at the day of admission, day 3 and day 7.
Study Type
OBSERVATIONAL
Enrollment
100
blood sampling at the day of admission, day 3 and day 7
University Hospital Angers
Angers, France
RECRUITINGACE2 level change over time
ELISA test (Higher the ACE2 level, higher the virus penetrate cells)
Time frame: at the day of admission, day 3 and day 7
ACE2 activity over time
Ratio angiotensin (1-7)/angiotensin(1/10) (Higher Ratio angiotensin (1-7)/angiotensin(1/10), higher is ACE2 activity)
Time frame: at the day of admission, day 3 and day 7
Mortality at day 28
Mortality at day 28
Time frame: day 28
ARDS severity
PaO2/FiO2 ratio (ARDS is severe when \<100, moderate when between 100 and 200, mild when \>200)
Time frame: from the day of admission to day 7
Duration of mechanical ventilation
Day under mechanical ventilation
Time frame: from the day of admission to day 28
Need for prone positionning
Need for prone positionning
Time frame: from the day of admission to day 28
Need for extracorporeal membran oxygenation
Need for extracorporeal membran oxygenation
Time frame: from the day of admission to day 28
Use of paralytic agents
Need for use of paralytic agents
Time frame: from the day of admission to day 28
Need for renal replacement therapy
Need for renal replacement therapy
Time frame: from the day of admission to day 28
Need for vasoactive drugs (norepinephrine, dobutamine,epinephrine)
Need for vasoactive drugs
Time frame: from the day of admission to day 28
Sequential Organ Failure Assessment (SOFA) score
The SOFA score evaluates the severity of patients through 6 items: respiration (PaO2/FiO2 ratio); coagulation (platelets count); liver (bilirubin); Cardiovascular (hypotension); Central nervous system (coma glasgow score) and Renal (creatinine serum level). Score ranges from 0 to 24, a higher score indicates higher severity and probability of death
Time frame: from the day of admission to day 7
Number of session(s) of prone positionning
Number of session(s) of prone positionning
Time frame: from the day of admission to day 28
Duration of extracorporeal membran oxygenation treatment
Duration of extracorporeal membran oxygenation treatment
Time frame: from the day of admission to day 28
Type of vasoactive drugs
Several vasoactive agents may be used: norepinephrine, dobutamine, epinephrine, vasopressin analogues...
Time frame: from the day of admission to day 28
Duration of vasoactive treatment
Duration of vasoactive treatment
Time frame: from the day of admission to day 28
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